Immune-related adverse events signal better survival in non-Hodgkin lymphoma patients on ICI

The development of immune-related adverse events (irAEs) in non-Hodgkin lymphoma (NHL) patients treated with immune checkpoint inhibitors (ICI) may indicate better long-term survival, a recent study has found.

Thirty-two patients (mean age at diagnosis 31 years, 20 women) participated in the study, of whom 20 were taking ICI as a single agent while 12 received it in combination with other treatments. Participants had previously received a median of three therapies, including six who had undergone autologous stem cell transplantation.

The objective response rate to ICI was 43.8 percent, with a 31.6-percent complete response rate. Aside from the 10 patients who achieved complete response, two showed partial response and two reached stable disease; meanwhile, 18 saw disease progression, five of whom died.

Ten patients developed at least one irAE, yielding a total of 17 irAEs overall. Two of such side effects were grade ≥3 and three were deemed to be serious. Over a median follow-up of 48.0 months, the researchers recorded a 40.6-percent progression-free survival at 24.0 months, which was nominally higher in patients with vs without irAEs (40.0 percent vs 31.8 percent; p=0.5442).

Overall survival showed a similar pattern, with patients developing irAEs showing slightly better rates at 24.0 months (62.5 percent vs 40.0 percent; p=0.4718). Overall survival in the complete cohort was 44.8 percent.

“These differences were not significant, but data supported the hypothesis that the highest activity of ICIs is associated with irAEs occurrence, which may be considered a clinical biomarker for ICI response,” the researchers said. [Blood 2019;129:3071-3073]

“With the increasing use of immunotherapy in lymphomas therapeutic algorithms, physicians must be aware about the drug-related irAEs, their recommended management, monitoring and about the best actions to be taken to avoid treatment discontinuation and, consequently, loss of patients’ response,” they added.